Cuidado paliativo: una aproximación a los aspectos éticos en el paciente con cáncer

Abstract

The current epidemiological profile has let the way allowing chronic and degenerative diseases such as cancer to occupy the first morbimortality places in the medical picture. In the service offered to these patients, palliative care actually plays a role in the disease, from beginning to end, where it becomes the center of attention with an integral management enabling the givers to improve these patients’ quality of life. Palliative care stresses the dignity of the suffering individual, and takes care of its different dimensions through therapeutic, interdisciplinary and specialized teams. The care of these patients at the end of their lives reveals a series or complex problems from the ethical point of view, including aspects of sanitary justice like the following: The absence of health policies ensuring the implementation and development of pain and palliative care units; the lack of proper availability of opioids to deal with pain; difficulties in the understanding of disease stages and the type of treatments that should be offered as considered proportionate and/or ordinary/useful, versus those seen as disproportionate and/or extraordinary/useless; and communication problems with respect to family information and the way to approach the relatives, among others. Likewise, among other factors, the non-proper care of terminal patients has led to suggesting measures that contradict the dignity of the human individual, such as euthanasia and assisted suicide with their resulting ethical implication. This work offers an outlook of end-of-life ethical problems as seen from the experience in dealing with the patient, and rehabilitates the importance of palliative care in the integral service given to these patients from the first stages to the very end of their illness.